Emetics

Overview of Emetics:

• Emetics are agents used to induce vomiting, primarily to remove toxic substances from the stomach before absorption into the bloodstream.
• They work by activating the body’s natural vomiting reflex, involving both the central nervous system and the gastrointestinal tract.

Mechanism of Action of Emetics:

• Vomiting, or emesis, is regulated by the brain’s vomiting center in the medulla oblongata.
• This center can be activated by:
  • Direct irritation of the stomach or intestines.
  • Activation of the chemoreceptor trigger zone (CTZ), which detects toxins in the blood.
  • Sensory inputs such as sights, smells, or emotions.
• When activated, the vomiting center coordinates muscle contractions to expel stomach contents.

Common Emetics

1. Ipecac Syrup

   • Derived from the ipecacuanha plant, it induces vomiting by irritating the stomach lining and stimulating the CTZ.
   • Historically used in poisoning cases, but its use has decreased due to safety concerns and potential for abuse.

2. Apomorphine

   • Acts centrally by stimulating dopamine receptors in the brain to induce vomiting.
   • Administered subcutaneously or intravenously under medical supervision due to potential side effects like respiratory depression and hypotension.

Considerations and Cautions

• Nature of the Poison:

  • Emetics are contraindicated if the ingested substance is caustic (acids or alkalis) or petroleum-based, as vomiting could cause further harm.

• Patient Condition:

  • Not suitable for patients who are unconscious, convulsing, or unable to protect their airway, due to the risk of aspiration.

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